Role of adipose tissue insulin resistance in the natural history of type 2 diabetes: Results from the san antonio metabolism study

Amalia Gastaldelli, Melania Gaggini, Ralph A. DeFronzo

Producción científica: Articlerevisión exhaustiva

225 Citas (Scopus)

Resumen

In the transition from normal glucose tolerance (NGT) to type 2 diabetes mellitus (T2DM), the role of b-cell dysfunction and peripheral insulin resistance (IR) is well established. However, the impact of dysfunctional adipose tissue has not been fully elucidated. The aim of this study was to evaluate the role of resistance to the antilipolytic effect of insulin (adipose tissue IR [Adipo-IR]) in a large group of subjects with NGT, impaired glucose tolerance (IGT), and T2DM. Three hundred two subjects with varying glucose tolerance received an oral glucose tolerance test (OGTT) and euglycemic insulin clamp. We evaluated Adipo-IR (fasting and mean OGTT plasma free fatty acid [FFA] 3 insulin concentrations), peripheral IR (1/[Matsuda index] and (M/I)21 value), and b-cell function (calculated as the ratio of the increment in plasma insulin to glucose [OGTT/IR (DI/DG 4 IR)]). Fasting Adipo-IR was increased twofold in obese subjects with NGT and IGT versus lean subjects with NGT (8.0 6 1.1 and 9.2 6 0.7 vs. 4.1 6 0.3, respectively) and threefold in subjects with T2DM (11.9 6 0.6; P < 0.001). Progressive decline in DI/DG 4 IR was associated with a progressive impairment in FFA suppression during OGTT, whereas the rise in mean plasma glucose concentration only became manifest when subjects became overtly diabetic. The progressive decline in b-cell function that begins in individuals with NGT is associated with a progressive increase in FFA and fasting Adipo-IR.

Idioma originalEnglish (US)
Páginas (desde-hasta)815-822
Número de páginas8
PublicaciónDiabetes
Volumen66
N.º4
DOI
EstadoPublished - abr 1 2017

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Huella

Profundice en los temas de investigación de 'Role of adipose tissue insulin resistance in the natural history of type 2 diabetes: Results from the san antonio metabolism study'. En conjunto forman una huella única.

Citar esto